Archive for May, 2012
Telepresence, micropresence, and telerobotics hold promise for allowing expert physicians
to assist clinicians and surgeons at remote locations. Telepresence allows a physician to
have access to a distant location through static or full-perspective views of a patient. Highfidelity
telepresence allows a remote location or scene to be inspected from different
perspectives via a procedure of moving distant cameras in concert with the head and gaze
positions of a local observer. Telerobotics allows the telepresent clinician to interact with a
distant patient. Simple forms of telepresence and telerobotics have already become popular
in pathology diagnosis. In telepathology, a surgical pathologist has instant access to a
microscope and a slide of a patient’s biopsy at a distant site. Telepathology systems that
communicate via satellite and over the telephone lines have been developed. Several
groups, including teams at NASA, and within the SRI International bioengineering group,
have developed interesting demonstration technologies that display the effectiveness of
telerobotics for exploring and manipulating objects at a distance. Some telepresence
projects demonstrate strides in developing force-feedback techniques, which allow a user to
feel the texture, elasticity, or weight of distant objects and structures.
We have been investigating a derivative of telepresence, called micropresence, at the Palo
Alto Laboratory. Micropresence can enable physicians to explore and to perform
procedures on compact, complex regions of a patient’s anatomy, while minimizing the
extent of surgical incisions. Micropresence involves the positioning of one or more small
CCD television cameras and associated camera-control systems in hard-to-reach or
compact areas of a patient’s anatomy. Such cameras have the ability to image and enlarge
complex anatomic regions of interest, as well to identify the exact position of teleoperated
microsurgery tools. Micropresence could allow surgeons to explore small or hidden areas
from different perspectives, and to perform surgical procedures in these areas as if the
regions of interest were expanded greatly, or even made to surround a physician. In
essence, a surgeon would be endowed with the ability to explore complex regions, and
maneuver tele-operated tools as if he or she were reduced in size, and could step into these
We focused, in particular, on technologies that can help physicians make more effective use
of computers that offer assistance with decision making. There is great opportunity for
enhancing future healthcare delivery by integrating medical-informatics software with
evolving human—computer interaction technologies.
Since August 2006 we have experimented with infrastructures and methods to facilitate
creativity and innovation in software development. We aim to build creative settings for
team-based software development using modern development principles. These principles
allow for flexible and incremental development and thus for incorporating new ideas even
late in a project. We expect these principles to widen the window of opportunity for creativity
and innovation by allowing learning experiences and discoveries from an ongoing project to
feed ideas back into the project itself.
The main thrust in our research is the design of Essence. Among the ideas are:
- Supporting creativity and innovation through all phases in the development project.
- Integrating into and extending existing development methods.
- Melding creative sessions with agile development to increase development speed and
maintain flexibility in the project.
- Entrusting the development team – rather than external specialists – to be creative.
- Collective idea-generation in self-organizing teams.
- Using multiple perspectives to support divide-and-conquer strategies.
- Maintaining holistic overview via systematic separation.
- Kinesthetic thinking – using physical location and movement to support simulation and
We call Essence a method concept, not a method per se, to stress that Essence will find its
actual form as the individual teams use and adapt it through daily routines, and integrate
Essence into their main development method, e.g. Scrum.
To support multiple perspectives we find inspiration in the four generic views: Earth,
Water, Fire and Air named by Empedocles of Acragas (ca. 495- 435 BCE). In his
Tetrasomia, or Doctrine of the Four Elements Empedocles argued that all matter is comprised
of these four elements. Essence is named after Quintessence, the cosmic fifth element added
by Aristotle to complement the four earthly elements.
Essence is intended to be lightweight, easy, and fun to use. Lightweight in the sense that
ceremony and project overheads are kept at a minimum, so as not to have projects leave out
Essence for lack of time. Easy to use in the sense, that the time needed before Essence is
useful should be short, and the activities in Essence should come naturally to the participants.
Finally, it should be fun to use, to raise motivation.